Treatment and Course of Community-Acquired Pneumonia Caused by Atypical Pathogens

Álvarez, Ramón Fernández; Toste, Isabel Suárez; Cuadrado, Gemma Rubinos; Gonzálvez, Agustín Medina; Gullón Blanco, José Antonio; Martín, Isidro González

doi:10.1016/S1579-2129(06)60564-8

Archivos de Bronconeumología

ISSN: 0300-2896

Archivos de Bronconeumologia is an international journal that publishes original studies whose content is based upon results of research initiatives dealing with several aspects of respiratory medicine including epidemiology, respiratory physiology, pathophysiology of respiratory diseases, clinical management, thoracic surgery, pediatric lung diseases, respiratory critical care, respiratory allergy and basic research. Other types of articles such as editorials, reviews, and different types of letters are also published in the journal. Additionally, the journal expresses the voice of the following scientific societies: the Spanish Respiratory Society of Pneumology and Thoracic Surgery (SEPAR; https://www.separ.es/), the Latin American Thoracic Society (ALAT; https://alatorax.org/), and the Iberian American Association of Thoracic Surgery (AIACT; http://www.aiatorax.com/).

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Vol. 42. Issue 9.

Pages 430-433 (September 2006)

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Pages 430-433 (September 2006)

Original Articles

DOI: 10.1016/S1579-2129(06)60564-8

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Treatment and Course of Community-Acquired Pneumonia Caused by Atypical Pathogens

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Ramón Fernández Álvarez

Corresponding author

enelllano@terra.es

Correspondence: Dr. R. Fernández Álvarez. San Juan Bautista, 19, A. 38002 Santa Cruz de Tenerife. España

, Isabel Suárez Toste, Gemma Rubinos Cuadrado, Agustín Medina Gonzálvez, José Antonio Gullón Blanco, Isidro González Martín

Servicio de Neumología, Hospital Universitario de Canarias, La Laguna, Santa Cruz de Tenerife, Spain

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Objective

To study the course of disease and outcomes in a group of patients with community-acquired pneumonia caused by atypical pathogens (Mycoplasma pneumoniae, Legionella species, Coxiella burnetii, and Chlamydophila pneumoniae) according to the empiric treatment received.

Patients and methods

Of a total of 390 patients admitted to our hospital with pneumonia between January 1996 and February 2001, the causative microorganism was an atypical pathogen in 89 cases. Patients were divided retrospectively into 2 groups according to the empiric treatment they received: group A, who had received an antibiotic regimen (quinolones or macrolides) that provided coverage for atypical pathogens; and group B, who had received treatment that did not provide such coverage. Clinical course was assessed in terms of the differences between the 2 groups in length of hospital stay, radiographic resolution, readmission at 30 days after discharge, and mortality.

Results

A total of 89 patients with pneumonia caused by atypical pathogens (39 in group A and 50 in group B) were studied. No significant between-group differences in the variables were found.

Conclusions

In this group of patients hospitalized for community-acquired pneumonia, antibiotic regimens providing coverage for atypical pathogens did not improve either clinical or radiographic evolution.

Key words:

Antibiotic treatment for pneumonia

Community-acquired pneumonia

A typical pneumonia

Objetivo

Estudiar la evolución de un grupo de neumonías extrahospitalarias causadas por gérmenes atípicos (Mycoplasma pneumoniae, Legionella spp., Coxiella burnetii y Chlamydophila pneumoniae) en función del tratamiento empírico recibido.

Pacientes y métodos

Entre enero de 1996 y febrero de 2001 ingresaron en nuestra unidad 390 casos de neumonía, de los que 89 estaban causados por gérmenes atípicos. Los pacientes se dividieron retrospectivamente en 2 grupos según el tratamiento empírico pautado: grupo A, al que se había proporcionado cobertura frente a gérmenes atípicos (quinolonas o macrólidos), y grupo B, al que no se había proporcionado dicha cobertura. Se estudió la evolución según las diferencias entre ambos grupos en la estancia hospitalaria, la resolución radiológica, el reingreso en el primer mes tras el alta y la mortalidad.

Resultados

El grupo de estudio lo constituyeron 89 pacientes con neumonía causada por gérmenes atípicos (39 en el grupo A y 50 en el B). Las variables estudiadas no mostraron diferencias significativas entre ambos grupos.

Conclusiones

En nuestra serie de neumonías extrahospitalarias la cobertura antibiótica frente a gérmenes atípicos no mejoró la evolución clínica y radiológica de los pacientes.

Palabras clave:

Tratamiento antibiótico de la neumonía

Neumonía adquirida en la comunidad

Neumonía atípica

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